Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.gov <br />_ ,- <br />� I � N2.- ���i�� ��.,�,�,, .` � � L.� ��- � , �, 4 <br />, � _ v ��_ � ���:�-�- ��� ��;� � �, �: _ _ ' <br />PROJECT ADDRESS �� <br />� ,.� � �: <br />€ t <br />r�s ' , ',,,� z� y%,��1. %� � 'e} t ''�, � � � -�� l��� � �•`�"_ � L.�. iti1 ; ��. � (� b C:� G('� � � t,. v,� <br />Owner Mail Address City State/Zip <br />������ � �� i� lt� ��F� o Y�� � ���_,����,� l. �;� C t�� Y(_. 7, c� ..� �� �7 . C�����-t %p ' yj� <br />�� <br />Tenant Mail Address City - State/Lip <br />� �� n ��i �'I � <br />Electrical Contractor <br />� � <br />Mail Address <br />State License Number (required) <br />�_�.' i,'`',,` �''i,';.--'�=- �"v �,. .�.�v <br />Proposed Use of 8uilding <br />�_.� i, v� L4�2 �C�. d. .:c,.� <br />I Square Footage (If residential new construction, remodel or addition} <br />� <br />I Number of devices (If low voltage) <br />Descnption of Work to Be Done: ���� �r� ����'� °'�'� <br />�� � s �_ � � }- <br />. _ d �w �_� � �, - t _s, �.�� <br />City <br />State/Zip <br />l �,�.� 5�s j��, i <br />Phone <br />t.'t��.S �tE... ��;. �-'f ij-� � <br />i �� <br />Phone ; <br />Phone <br />City of Everett Business License Number (required) <br />� � � � . .�Y 1 `l _,, <br />: <br />Contract Price of Work <br />��c:.i�i� ��°ix.�� �� , isa,�.�o. t t��° �"��..1'�� 1 <br />Contact Person/Contact Number/Email <br />r� <br />��`i z�� a�'. �. Y`7 1. �»- C y td �s"�..,1 ��: � <br />� <br />i _, : � t �, C F �'`�.,� 'L �: �,. - !� t °.. .��t� �-`�_._a � l.: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � �� <br />I hereby cerfify that 1 have �ead and examined this app6cation and know the same to be true and � <br />� correct. Rll provisions oflaws and ordinances governing this type of work will6e completed <br />whether specifred herein or not The grant+ng of a permit does not presume to give authority to PERMIT# <br />� violate or r.ancel the provisions of any ofher state or /ocal /aw regulating construction or the �„� J �� <br />i performance of construction. That i am authorrzed by the owner of this property to perform the I� � � � <br />w o r k f o r w h i c h a p p lrca tion is ma de an d I comp ry wi t h t he S tate Contractors Law 18.27 RCW and <br />' 296.200 WAC. <br />�-� �, , <br />� ��� 1 �.� <br />� ��1�� C� <br />� <br />RcVISED 08/05?074 <br />Date <br />'i/ <br />